Cayenne: The hot herb that cools pain

Americans are riding a heat wave. Not left over from the summer's blistering sun, but from cayenne, the hot-selling hot pepper supplement. Also simply called red pepper, cayenne (Capsicum annuum or C. frutescens) is closely related to other notorious hot fellas, such as jalapeno, habafiero and tabasco peppers, as well as to their more mild-mannered cousins--paprika, pimento and bell peppers.

These days, however, cayenne is used more medicinally than to spice up foods. That's not new. South and Central American Indians appreciated the medicinal uses of cayenne 9,000 years ago.

What it Might Do: Traditionally, cayenne has been consumed to increase perspiration, stimulate saliva and gastric juices, whet the appetite and--ironically, considering its hot bite--reduce pain from mouth sores and toothaches. Cayenne is now also touted to benefit the cardiovascular system, treat colds and speed metabolism, though scientific backing for these claims is limited.

Despite the popularity of cayenne supplements, the strongest clinical evidence is for use externally to relieve the pain of shingles, diabetic neuropathy, cluster headaches, rheumatoid arthritis and osteoarthritis, as well as phantom pain following mastectomies and amputations. Over-the-counter sale of topical creams and ointments containing capsaicin, the active ingredient in cayenne, is approved by the Food and Drug Administration.

How it Works: Capsaicin is the fiery substance in cayenne that acts as a topical analgesic. It does this by depleting substance P, a chemical messenger that sends pain signals to the brain.

If You Take: As a dietary supplement, cayenne is sold as capsules and tinctures. Topical creams and ointments include Zostrix Arthritis Pain Relief, Glades Capsaicin and Double Cap Topical Analgesic Cream, containing 0.025% to 0.075% capsaicin. Though package instructions may be more conservative, Varro Tyler, Ph.D., a noted herbal authority, believes results are best if these creams are applied four to five times a day for at least four weeks.

Caution: Do not use capsaicin cream on broken or injured skin and avoid getting it in your eyes. Expect to feel it burn initially, although this lessens with repeated applications. Used internally, excessive ingestion can cause gastroenteritis or damage to the kidney or liver. Cayenne may also interfere with MAO inhibitors and high blood pressure medication.

EN Weighs In: Cayenne is best used topically to relieve chronic pain. The benefits of cayenne as a dietary supplement are less clear. If you take it, exercise caution. Of course, using cayenne as a spice is safe in any amount you can comfortably consume. It not only adds fire to a dish, it also provides some vitamin C and carotenoids.